Multiple myocardial infarctions associated with atheromatous emboli after PTCA of saphenous vein grafts. A clinicopathologic correlation.

Abstract:

:Percutaneous transluminal coronary angioplasty (PTCA) of stenotic saphenous vein grafts is less invasive than repeat coronary bypass grafting; however, this procedure is complicated by atheromatous embolization in 2.5%-3.0% of cases, an incidence significantly higher than in angioplasty of native coronary vessels. We reviewed the cases of 98 patients who underwent elective saphenous vein graft angioplasty at our institution. Five patients (5.1%) had non-Q-wave myocardial infarctions after the procedure, documented by elevated serum creatine kinase. In four, atheroembolism was suspected during the procedure. Two patients died, and autopsy showed that both had multiple atherosclerotic emboli to the distal epicardial coronary artery supplied by the vein graft. In addition, multiple infarcts of varying age, some clearly antedating the angioplasty procedure, were identified. These findings suggest that both ongoing, recurrent atheroembolism as well as angioplasty-related embolism may occur in older vein grafts.

journal_name

Cleve Clin J Med

authors

Trono R,Sutton C,Hollman J,Suit P,Ratliff NB

doi

10.3949/ccjm.56.6.581

subject

Has Abstract

pub_date

1989-09-01 00:00:00

pages

581-4

issue

6

eissn

0891-1150

issn

1939-2869

journal_volume

56

pub_type

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